Clayton Dabney for Kids with Cancer - Family Assistance Program

Geographic Scope: Texas, US (primary focus on Dallas/Houston area, but serves families statewide)

Mission: Provides gifts, last wishes, and financial assistance to terminal pediatric cancer patients and their families to facilitate quality of family life and create everlasting memories.

Eligibility Criteria

Families must meet ALL of the following criteria:

• Patient Diagnosis: Patient must be diagnosed with cancer or cancer-related illness
• Terminal Status: Patient must be terminal and in the last stages of their illness
• Age: Patient must be 18 years old or younger (exception: if child is 21 or younger and was diagnosed before turning 18 and is still being treated in a pediatric facility, they may still qualify)
• Financial Need: Family must qualify as low income or financially needy PRIOR to diagnosis. This should be determined by the referring hospital or hospice care team before submitting a request.
• Referral Requirement: Patient must be referred by a hospital or hospice care facility. Families cannot submit applications directly.

What Clayton Dabney Funds

• Gifts and last wishes that create meaningful memories
• Quality-of-life expenses (e.g., trips, entertainment, special experiences, items to enhance comfort)
• Examples include: family trips, birthday parties, entertainment experiences, home comfort items, technology for communication

What Clayton Dabney Does NOT Fund

• Medical bills
• Funeral-related expenses

Financial Parameters

• Maximum Award: $2,500 cap per family
• Award Type: One-time assistance per case

Contact Information

Program Director: Lauren Cockrill

• Phone: 214-361-2600
• Email: lauren@claytondabney.org
• Fax: 1-888-374-0131

Background

Clayton Dabney for Kids with Cancer serves needy families, including those in lower to middle income brackets where both parents work but are unable to take time off due to covering family expenses and medical bills.

Application Process

Important: Applications must be submitted by a hospital or hospice care facility on behalf of the family — families cannot apply directly.

Step-by-Step Process

1. Referral: Ensure the patient meets all eligibility criteria (see overview)
2. Financial Verification: The referring hospital or hospice care team must verify the family qualifies as low income or financially needy prior to diagnosis
3. Complete Forms: Fill out all required application forms in full (see Required Materials below)
4. Submit: Fax completed forms to 1-888-374-0131
5. Follow-up: Contact Lauren Cockrill with any questions during the process

Required Materials

• Case Request Information Form
• Case Liability Release Form
• Medical Authorization Form
• Case Request Change/Add Form (if applicable)

Submission Format

• Fax all completed forms to: 1-888-374-0131
• All forms must be completed in full

Questions

For questions about the application process, contact:

• Lauren Cockrill
• Phone: 214-361-2600
• Email: lauren@claytondabney.org